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83 Cards in this Set
- Front
- Back
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What 2 problems can every diarthrodial joint get?
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OCD
DJD |
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How many joint capsules in the fetlock? The carpus?
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Fetlock - ONE
Carpus - 2 capsules (radiocarpal; middle and carpometacarpal communicate) |
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What are the 3 anesthetic agents commonly used in equine joint/nerve blocks? Which has the fastest onset? Which has the longest duration?
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Mepivicaine (last 1.5-2hrs)
Lidocaine (fast onset, last 30 min) Bupivicaine (last 5-6 hrs) |
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Which block ONLY blocks the heels and sole?
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Palmar digital nerve block
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If you want to block the foot distal to the fetlock, which block is most appropriate? What nerves are affected?
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Abaxial sesamoid block; affects palmar digital nerves and dorsal branches as well
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Regarding the VAN triad on the abaxial sesamoid block, the nerve blocked lies...
a) more palmar/plantar b) more lateral c) in the center of the triad d) palmar on the medial n. and lateral on the lateral nerve. |
a) more palmar/plantar
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Which block anesthetizes distal to the fetlock and INCLUDING the fetlock? Which nerves are blocked?
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Low 4 point block
(blocks low palmar and low palmar metacarpal nerves) |
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Which block is used for the flexor tendons and distal check ligament?
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High 4 point block
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In which of the following blocks is swelling a possible sequel?
a) abaxial sesamoid b) low 4 point c) high 4 point d) palmar digital |
b) low 4 point
c) high 4 point |
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What joint block may be used to anesthetize the navicular bone?
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Coffin joint block
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What are normal values for WBC and protein in synovial fluid?
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WBC 140-180 (10% neuts; 90% monos)
Prot 1.5-2 |
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What are the joints of the carpus? Which ones intercommunicate?
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Radiocarpal joint (separate)
Intercarpal & Carpo-metacarpal (communicate) |
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The coffin joint is commonly blocked medial and lateral to which structure?
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Common digital extensor tendon
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What are the main articulations of the tarsal joint? Which joints intercommunicate?
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Tibiotarsal & Proximal intertarsal (communicate)
Distal intertarsal (separate) Tarsometatarsal (separate) |
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What are the 3 major compartments of the stifle? Which of these communicate?
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Femoropatellar & medial femorotibial (communicate)
Lateral femorotibial (separate) |
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The most commonly affected joint compartment of the equine stifle is...
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Femoropatellar
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Which of the following predispose the fetlock to injury?
a) large range of lateral motion b) lack of soft tissue covering c) 2 sesamoid bones d) small cross sectional area of weight bearing surfaces e) low range of motion |
b) lack of soft tissue covering
d) small cross sectional area of weight bearing surfaces (also LARGE range of motion) |
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Chronic thickening of the joint capsule without osseous radiographic lesions describes...
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...green osslets
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How is chronic proliferative synovitis treated?
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Steroids + rest
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Where do fractures tend to occur in P1? Which horses get them?
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dorsal proximal margin on the medial side; more in racehorses
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When should P1 fractures be treated? How are they treated?
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Treat when fracture is causing a lameness (otherwise dont' treat); Tx via arthroscopic removal w/o curettage
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Which breeds get sagittal and spiral P1 fractures?
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Standardbreds
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Where do sesamoid fractures occur and which has the best and worst prognosis?
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Apical (best prognosis)
Mid-body (worst prognosis) Basilar (bad prognosis) |
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What structures attach to the sesamoids?
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Suspensory ligament proximally
Distal sesamoid ligaments distally Intersesamoidean ligament |
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Which breeds get sesamoid fractures most often and where?
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Thoroughbreds (right lateral forelimb)
Standardbreds (right lateral hindlimb) |
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Which radiographic view is best to see cannon bone condylar fractures?
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DP view
Use DPMS 125 for evaluation of articular portion of fracture |
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Where do most condylar fractures of the cannon bone occur?
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Lateral aspect; left front leg
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What are the major articulations of the carpus? Which intercommunicate?
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Radiocarpal (doesn't communicate)
Intercarpal Carpometacarpal (last 2 communicate) |
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What nerve, artery, and vein bundle is found on the medial side of the flexor tendons?
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Medial palmar n, a, and v
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T or F:
The majority of carpal motion is in the radiocarpal and middle carpal joints. |
True!
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How is "calf knees" treated? What serious sequel often occurs due to calf knees?
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No treatment
Can cause chip fractures |
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Which carpal conformation puts stress on the sesamoids and suspensory apparatus? How is this treated?
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Bucked knees (over at the knees)
Tx - corrective casting, splinting, tetracycline, or surgery |
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What is the difference between a chip and a slab fracture?
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Chip = 1 joint surface
Slab = 2 joint surfaces |
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What is the most common slab fracture in the horse? What is the most common chip fracture?
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3rd carpal bone (slab)
distal radiocarpal bone in middle carpal joint (chip) |
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T or F:
Anesthesia into the radiocarpal joint will not improve lameness in most chip fractures of the carpus. |
True! Most chips are in the middle carpal joint (off of the distal radiocarpal bone)
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How are carpal slab fractures treated?
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Remove if <8mm; lag screw if larger
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What is the most common problem diagnosed in the equine carpus?
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Carpitis (DJD of carpus)
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How is carpitis treated?
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rest, maybe steroid joint injection (must REST w/steroids or degeneration gets worse)
Maybe HA |
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What is a fluid-filled bursa over the carpus? How is it treated?
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Hygroma
Drainage, pressure wraps, maybe steroids, surgery, or cryosurgery |
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What should be done before treating any hygroma?
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Ensure that it doesn't communicate with the joint!
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What are the two major swellings over the carpus?
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Hygroma
Synovitis of ECR sheath (just proximal to carpus) |
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Which needle sizes would be appropriate for local anesthesia? For intraarticular anesthesia?
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Local (25 & 22ga)
Intra-articular (22-18 ga) |
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How do you say periostitis over the dorsal cannon bone in horse language?
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Bucked Shins
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Which structure prevents excessive dorsal flexion of the fetlock?
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Suspensory ligament (interosseous muscle)
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Which of the following are signs of type 1 bucked shins?
a) lameness b) pain on palpation c) thickening of dorsal cortex of cannon bone d) young horses e) fractures of dorsal cortex of cannon bone |
b) pain on palpation
d) young horses (usually no radiographic changes) |
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Which of the following are signs of type 2 bucked shins?
a) lameness b) pain on palpation c) thickening of dorsal cortex of cannon bone d) young horses e) fractures of dorsal cortex of cannon bone |
a) lameness
b) pain on palpation (usually older horses; can feel changes in cannon bone and get supberiosteal callus) |
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Which of the following are signs of type 3 bucked shins?
a) lameness b) pain on palpation c) thickening of dorsal cortex of cannon bone d) young horses e) fractures of dorsal cortex of cannon bone |
a) lameness (obvious)
b) pain on palpation e) fractures of dorsal cortex of cannon bone (usually on middle to distal 1/3 of cannon) |
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What are saucer fractures associated with? How can you tell if the fracture penetrates into the medulla?
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Type 3 dorsal cannon periostitis (see focal sclerosis within medullary canal = penetration)
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What are treatment options for type 3 dorsal cannon periostitis?
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Rest (4-6 months)
Shockwave Sx (lag screw or forage) |
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Which condyle is most often fractured in the cannon bone? What are associated conditions with this?
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Lateral condyle
Associated w/P1 fractures, DJD of the fetlock, and sesamoid fracture |
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How do you say "irritation and sprain of the interosseous ligament leading to periostitis" in horse-ese?
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Splints
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How is a splint treated?
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NSAIDs
Rest (30-45d confinement) Ice & pressure Corrective shoes Maybe steroids Maybe US or Sx |
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What are indications for surgical removal of a splint fracture?
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Sore (nonunion)
Infected Impingement on suspensory ligament (big callus) |
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How are metacarpal/tarsal fractures treated?
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Compression plates are best (one for young; 2 for adult)
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What are the joints of the tarsus? Which ones communicate?
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Tibiotarsal
Tarsometatarsal Proximal and distal intertarsal (Tibiotarsal and proximal intertarsal communicate) |
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Which tarsal bone spans both rows? Which way is the talus oriented?
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4th tarsal bone spans both
Talus "points" laterally |
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The cunean tendon is an extension of which structure?
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Split tendon from cranial tibial m.
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Which tarsal joint moves the most?
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Tibiotarsal joint
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How is cunean bursitis treated?
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NSAIDS
corrective shoeing Training modification |
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Which joints does bone spavin affect? Which side?
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Distal intertarsal and tarsometatarsal joints
(medial side) |
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Which of the following is NOT a treatment for bone spavin?
a) rest b) steroid injection c) surgical arthrodesis d) NSAIDs e) corrective shoeing |
a) rest
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If you see a horse move its rear legs in an arc from medial to lateral, what does it probably have?
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Bone spavin
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What conformation abnormalities may contribute to OA of the hock?
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Sickle-hocked
Straight/upright hock |
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How do you say bursitis of the tuber calcaneus in horsespeak?
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Capped hock
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How is capped hock treated?
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Behavior/environment modification
rest & NSAIDs |
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How do you say desmitis of the plantar ligament in horsespeak?
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Curb
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Why should your horse not eat false dandelions?
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they'll get STRINGHALT
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What are some differential diagnoses for a horse with hyperreflexia in the hind limbs?
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Stringhalt
Old laceration near the hock EPM |
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Which of the following is NOT associated with stringhalt?
a) unknown etiology b) can be unilateral or bilateral c) pain d) involuntary flexion of the hock |
c) pain
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How is stringhalt treated?
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Remove from pasture
Lateral digital tendonectomy |
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What is the horse-speak name for tenosynovitis of the DDF sheath proximal to the hock?
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Thoroughpin
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How is thoroughpin treated?
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Drainage and pressure wrap
Steroids Surgery??? |
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What are the common areas for OCD in the hock? Which is most common?
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DIRT (most common)
Lateral trochlear ridge Either malleolus |
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What is horse-speak for OCD in the hock?
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Bog spavin
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If you find an OCD lesion in the hock, what should you do next?
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Check the other hock!
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What are the synovial compartments of the stifle, which is the largest, and which communicate?
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Femoropatellar (largest)
Medial femorotibial Lateral femorotibial (first 2 often communicate) |
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Where does OCD in the stifle occur most often?
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Lateral trochlear ridge
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What are contraindications for stifle surgery due to OCD? What gives a bad prognosis for OCD here?
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Young
No bone flaps (patellar involvement is BAD) |
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What age is OCD in the stifle often seen? How about osseous cysts in the stifle?
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OCD <2yrs
Cysts 2-4 yrs |
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Where do osseous cysts in the stifle occur?
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Medial femoral condyle
|
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An outward arc in rear-leg motion indicates pain in what area?
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Stifle pain
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T or F:
Stifle lesions will often not block out completely with intra-arthrodial anesthesia. |
True!
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How are OCD cysts treated?
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Arthroscopic curettage
Steroids + bone marrow/stem cell aspirates or platelet-rich plasma |